Trends in the Utilization of Lipid-Lowering Medications in Australia: An Analysis of National Pharmacy Claims Data

• Published in: Current problems in cardiology Vol. 47; no. 7; p. 100880
• Main Authors: Talic, Stella, Marquina Hernandez, Clara, Ofori-Asenso, Richard, Liew, Danny, Owen, Alice, Petrova, Marjana, Lybrand, Sean, Thomson, David, Ilomaki, Jenni, Ademi, Zanfina, Zomer, Ella
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2022
• ISSN: 0146-2806; 1535-6280
• DOI: 10.1016/j.cpcardiol.2021.100880

•Lipid-lowering medications comprise standard of care in the prevention of cardiovascular disease.•Statins still remain the most prevalent lipid-lowering medication dispensed in Australia.•Dispensation of non-statin medications, such as ezetimibe and combination medication (ie, statins and ezetimibe) and proprotein convertase subtilisin/kexin type 9 inhibitors, remains low but is increasing.•Investigation into the opportunities for non-statin cost-effectiveness would benefit a contemporaneous review of the impact or potential of non-statin lipid-lowering therapies, alone or in combination, and should be assessed in conjunction with real-world clinical outcome. Lipid-lowering medications comprise standard of care in the prevention of cardiovascular disease. This study examined the trends in the utilization of statin and non-statin medications in the Australian general population between 2013 and 2019. Pharmacoepidemiological analyses were performed using pharmacy dispensing data from Australian Pharmaceutical Benefits Scheme. One-year prevalence and incidence of statin and non-statin prescribing patterns were reported, and relative variations in prescribing examined via Poisson regression modelling. The one-year prevalence of statins’ prescriptions decreased between 2013-2019 by 5.5% (from 25.0%-19.5%). Females were less likely than males to be prescribed statins (rate ratio [RR]=0.90, 95% confidence interval [CI] 0.89-0.91). The one-year prevalence of ezetimibe alone, and in combination with statins, increased consistently from 2013-2019 from 1.5%-3.6% (P<0.01) and 0.1%-1.1% (P<0.01), respectively. The prevalence was higher among those aged 61-80 years (RR=1.20, 95%CI 1.10-1.21) and those aged older than 80 years (RR=1.34, 95%CI 1.22-1.47), when compared to people aged <60 years. The incidence of ezetimibe prescriptions was highest in people aged 61-80 years (RR=1.36, 95%CI 1.31-1.41) compared to those aged <60 years. The one-year prevalence of proprotein convertase subtilisin/kexin type 9 inhibitor prescriptions was highest among those aged 46-60 years (RR=1.24, 95%CI 0.97-4.97) compared to people aged <46 and >60 years. Females were less likely than males to be prescribed a proprotein convertase subtilisin/kexin type 9 inhibitor (RR=0.87, 95%CI 0.75-0.98). Statins remain the most prevalent lipid-lowering medication prescribed in Australia. The prescribing of non-statin medications remains low, but is increasing.